title: Minimally invasive treatment of displaced intra-articular calcaneal fractures using the balloon kyphoplasty technique: preliminary study.
abstract: BACKGROUND
  The balloon kyphoplasty approach to the treatment of vertebral fractures can be adapted to achieve the reduction and cement stabilisation of intra-articular compression fractures at other sites, such as the calcaneus.
  
  
  METHODS
  We studied six patients with a median follow-up of 12 months (range, 6-30 months). Fluoroscopy guidance was used to obtain optimal balloon positioning under the joint depression site. Reduction was achieved by expanding the balloon and stabilisation by injecting the cavity with resorbable tricalcium-phosphate cement in the younger patients and polymethyl-metacrylate cement in the two elderly patients with osteoporosis. No internal fixation was used.
  
  
  RESULTS
  No intra-operative, postoperative, or delayed complications were recorded. Median hospital stay length was 4.5 days (range, 3-7 days). All the fractures healed within the usual timeframe, without loss of reduction. Median time to full weight-bearing ambulation was 52.5 days (range, 15-75 days). The functional outcomes correlated with the good anatomic results, with a median American Orthopaedic Foot and Ankle Society score of 87.0 (range, 86-97).
  
  
  CONCLUSIONS
  This preliminary study shows that balloon reduction and cement fixation of intra-articular calcaneal fractures is easy to perform, reproducible, and devoid of specific complications. Good-quality reduction and stabilisation until fracture healing were achieved, and time to recovery of self-sufficiency was short, even in elderly patients with osteoporosis. These results support the use of this minimally invasive technique.
  
  
  METHODS
  Level IV, retrospective study.
authors.affiliation: Service de chirurgie orthopédique, centre hospitalier territorial de Nouméa, BP J5, Noumea, New Caledonia. Electronic address: jl.labbe@cht.nc.
authors.forename: J L
authors.initials: JL
authors.lastname: Labbe
authors.forename: O
authors.initials: O
authors.lastname: Peres
authors.forename: O
authors.initials: O
authors.lastname: Leclair
authors.forename: R
authors.initials: R
authors.lastname: Goulon
authors.forename: P
authors.initials: P
authors.lastname: Scemama
authors.forename: F
authors.initials: F
authors.lastname: Jourdel
mesh_terms: D000328:Adult; D000368:Aged; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D058498:Kyphoplasty / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013640:Tarsal Joints / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Balloon osteoplasty; Calcaneus; Cement stabilisation; Intra-articular joint depression fracture